Orthopedic surgeon or neurosurgeon?

[Dr. Smith]

I like Spine's suggestion of an neuro/ortho tag team.

Doc

[Spiney95]

Originally Posted by Dr. Smith

I like Spine's suggestion of an neuro/ortho tag team.

Doc

My last surgery was a 360 degree, three level disc./lam...cages, rods, yada yada. That one actually involved three surgeons. The ortho/neuros wanted a vascular surgeon to take them in and bring them out. I got documentation that the actual surgeon did the work as opposed to "supervising" a fellowship doc. I really don't have a problem being worked on by a fellow as long as the supervising surgeon is standing over his shoulder, not just on call in the building.

[Dr. Smith]

Originally Posted by spine95

My last surgery was a 360 degree, three level disc./lam...cages, rods, yada yada.

Wow. If you don't mind my asking, how did they do that - anterior/posterior/both?

Did they use titanium yada yada or the new synthetic composite yada yada?

Doc

[Spiney95]

Originally Posted by Dr. Smith

Wow. If you don't mind my asking, how did they do that - anterior/posterior/both?

Did they use titanium yada yada or the new synthetic composite yada yada?

Doc

A 360 is both anterior and posterior. This was almost seven years ago and they used titanium yada yada. I am told that the quality of my spine is much like someone with cancer of the spine. The ortho's sub specialty is spinal cancer. That sounds like a rather limitted area of interest but he gets patients from all over the country. Typically the anterior repair is done first. My location required going in between two major blood vessels that were very close together and considered risky. Enter the vascular surgeon. My understanding is that the neuro work was done from the front along with the lion's share of the clean up of old scar tissue and osteophytes. I was then rolled over and fused posteriorlly. The final step before closing was to drop in a grenade. Both incissions were 12 inches. I don't remember much as my pain doctor arranged for a pain specialist to take care of me until I could be transfered back home to a rehab hospital. . When I say that was my last surgery, I mean it was my last surgery. At 63, I can't tollerate anymore of that major spinal surgery, regardless of circumstances.

[Dr. Smith]

Originally Posted by spine95

I am told that the quality of my spine is much like someone with cancer of the spine.

I hear that. When I was DXed (in my 40s) the ortho told us I have the spine of a man in his 90s - whoopie. Not a candidate for surgery regardless.

The final step before closing was to drop in a grenade.

You got me. Root Beer all over my screen, keyboard, notebooks... everything.

Fascinating story, though - thanks.

Doc

[ejwblibby]

I would only ever trust a neurosurgeon to operate on my spine having had my first neck surgery carried out by an othopaedic surgeon. His approach was far more rough than the neurosurgeon. He took a huge chunk of bone from my hip when he did my fusions and he didn't secure the fusions with a plate or screws to support it. The lower fusion didn't take and It had to be done again. The second time around was by a neurosurgeon and he took a small chip of bone from my hip and I wasn't in nearly as much pain as I had been the first time. So without a doubt stick with the neurosurgeon. The spinal cord is part of the central nervous system - why trust it with anyone else?
Libby

Originally Posted by Teatime

Hi all! I've long had spine and joint problems so I'm not new to surgery but I am interested in knowing folks' opinions/preferences! About 20 years ago, I had a cervical diskectomy with fusion and it was done by a neurosurgeon. About 11 years ago, I had a laminectomy at L5-S1 and it was also done by a neurosurgeon.

My biggest problems that led to those surgeries were neurological. Numbness and tingling, loss of feeling, loss of motor skill in leg and arm, etc. So it made perfect sense to have a neurosurgeon do the work!

I've been struggling with back pain for about 3 years now and it's unrelenting. The neurosurgeon who did my laminectomy told me I'd likely need to have the disk space fused and worked on within 5 years. It's been 11 years so I've done pretty well! But an MRI showed absolutely no cushion left and my vertebrae are grating bone on bone. It needs to be fixed.

I'm having no neuro symptoms. It's strictly back pain. I've consulted an orthopedic spine specialist and he's recommended fusion and back stabilization that he says will resolve the problems for good. I've responded well to the previous surgeries so I think it will go well. My internist is wondering whether I should go to a neurosurgeon instead.

What do y'all think? I have surgery scheduled for May 22 but I still have plenty of time to consider everything.

[Spiney95]

If you are reasonably close to a teaching hospital, the repair could be done by a spinal ortho/neuro tag team. Each one does what he specializes in and you get the advantage of both perspectives. This does not mean that they are neccessarily in the same practice. Often it is just two surgeons who work well together. While the bulk of the surgery may be structural, a decompression might be involved. I would prefer having a neuro do the decompression.

Interesting side note.......you see both surgeons while in the pre-op mode. Generally speaking, the one you see first is the one who "takes the lead" and you will be interacting with more. Best wishes.